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A Colorado-based health system says it is denying organ transplants to patients not vaccinated against the coronavirus in “almost all situations,” citing studies that show these patients are much more likely to die if they get covid-19. The policy illustrates the growing costs of being unvaccinated and wades into deeply controversial territory — the use of immunization status to decide who gets limited medical care. The mere idea of prioritizing the vaccinated for rationed health resources has drawn intense backlash, as overwhelmingly unvaccinated covid-19 patients push some hospitals to adopt “crisis standards of care,” in which health systems can prioritize patients for scarce resources based largely on their likelihood of survival. (Knowles, 10/5)

It could pay to encourage your spouse to become vaccinated against COVID-19, especially as the financial cost of refusing to get the jab rises. Ochsner Health, the largest nonprofit health care system in Louisiana, announced it will charge workers an additional $200 per month to insure their unvaccinated spouses or partners covered by the hospital group's insurance policies, citing the high cost of caring for and treating patients with COVID-19. (Cerullo, 10/4)

The ferocity of the delta variant surge has delivered a serious financial blow to hospital systems in parts of the country with low vaccination rates that are struggling to care for coronavirus patients, even as they combat plummeting income, reduced bailout funds and higher labor costs. Many hospitals in Southern states and rural areas of the country — even in states with otherwise high vaccination rates — have been forced once again to temporarily curtail elective procedures such as hip replacements that bring in the most money. (Rowland, 10/5)

KHN: Major Insurers Running Billions Of Dollars Behind On Payments To Hospitals And Doctors 

Anthem Blue Cross, the country’s second-biggest health insurance company, is behind on billions of dollars in payments owed to hospitals and doctors because of onerous new reimbursement rules, computer problems and mishandled claims, say hospital officials in multiple states. Anthem, like other big insurers, is using the covid-19 crisis as cover to institute “egregious” policies that harm patients and pinch hospital finances, said Molly Smith, group vice president at the American Hospital Association. “There’s this sense of ‘Everyone’s distracted. We can get this through,’” she said. (Hancock, 10/6)

New York Gov. Kathy Hochul signed an executive order last week to ease the anticipated staffing challenges for health facilities once the vaccine mandate’s deadline passed. One provision in the order has health plans up in arms. What concerns insurers is the suspension of requirements for prior-authorization review for scheduled surgeries, hospital admissions, hospital outpatient services, home health services and inpatient/outpatient rehabilitation services following hospitalization. Concurrent and retrospective review of claims for inpatient and outpatient services also were suspended. In the governor’s order, the reason for the suspension is to increase availability of healthcare staff who might otherwise have been engaged in submitting or processing those tasks. (10/5)